EKGs

Question 1

Atrial hypertrophy

Answer 1

Biphasic P wave in II and V1

Initial component = RA, terminal component = LA

Question 2

Most common cause of RVH

Answer 2

LVH

Question 3

Causes of RAH

Answer 3

Pulmonary HTN
Tricuspid/pulmonary valve dz
PE
Congenital heart defects

Question 4

Causes of LAH

Answer 4

HTN
AMI
Mitral/aortic stenosis
LVH

Question 5

RVH

Answer 5

R wave > S wave in V1

Normally S wave > R wave in V1

Question 6

LVH EKG findings

Answer 6

LAH + voltage criteria (35 mm+)

Question 7

Voltage criteria for LVH

Answer 7

Deepest S in V1/V2 + tallest R in V5/V6

Question 8

Causes of LVH

Answer 8

systemic HTN

Mitral/aortic stenosis

Question 9

Strain pattern with LVH

Answer 9

Down sloping ST in V5/V6

Question 10

Ischemia

Answer 10

Inverted T or ST depression in 2+ contiguous leads (V1-V6)

Question 11

Injury

Answer 11

ST elevation 1+ mm in 2+ contiguous leads

Question 12

Infarct

Answer 12

Pathological Q waves (>.04 sec, deep –> 1/3 of QRS)

Question 13

Leads for Septal Infarct

Answer 13

V1, V2

Question 14

Leads for Anterior Infarct

Answer 14

V3, V4 (also V1, V2)

Question 15

Leads for Inferior Infarct

Answer 15

II, III, aVF

Question 16

Leads for Lateral Infarct

Answer 16

I, aVL, V5, V6

Question 17

Findings for posterior infarct

Answer 17

ST depression and tall R in V1, V2, V3

Question 18

Right ventricular infarct

Answer 18

inferior infarct + ST elevation in V4

Triad: hypotension, clear lung, JVD

Question 19

RBBB

Answer 19

Wide QRS with R’ > 0.12 seconds
In V1 and V2
(Broad S in V5 V6)

Question 20

LBBB

Answer 20

Double QRS in V5, V6, >0.12 sec

Deep S in V1, V2

Question 21

Effects of Calcium on EKG

Answer 21

Hypercalcemia: shortened QT
Hypocalcemia: prolonged QT, prolonged ST

Question 22

Effects of Potassium on EKG

Answer 22

Hyperkalemia: wide/flat P, wide QRS, peaked T
Hypokalemia: flat T, U waves, prolonged QT

Question 23

Effects of digitalis on EKG

Answer 23

Prolonged PR
Scooped out ST depression
Short QT, flat T waves

Question 24

WPW EKG findings

Answer 24

Shortened PR interval with delta R wave

Question 25

PE findings on EKG

Answer 25

S1 Q3 T3 (large S in lead I, large Q in III w/ T inversion)

Sinus tachycardia is most common finding

Question 26

Brugada Syndrome

Answer 26

RBBB with ST elevation in V1, V2, and V3

Inherited, M>F, can lead to syncope and sudden death

Question 27

Wellens Syndrome

Answer 27

unstable angina, stenosis of LAD –> anterior infarct

T wave inversion in V2 and V3

Question 28

Long QT Syndrome

Answer 28

> 0.44 seconds is abnormal

Question 29

Torsades de pointes

Answer 29

Two competitive irritable ventricular foci

D/t low K Mg Ca or congenital Long QT